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Osteochondral Lesions of the Talus

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Complications in Foot and Ankle Surgery

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Abstract

Osteochondral lesions of the talus involve articular cartilage damage and can frequently lead to pain, functional limitations, and disability. Effective cartilage repair techniques are imperative in providing symptomatic relief and returning the patient to activities of daily living, work, and sports. The surgical management of talar lesions remains a challenge, especially when faced with a failure of the primary procedure. Patients with residual osteochondral lesions of the talus typically present with chronic pain, instability, weakness, stiffness, or swelling in the ankle. Surgical treatment for osteochondral lesions of the talus includes arthroscopic debridement and marrow stimulation with microfracture, tissue transplantation with osteochondral autograft or allograft, autologous chondrocyte implantation, particulated juvenile cartilage grafts, and biologic augmentation. Surgical approaches are generally aided with an arthroscope, although open procedures are often necessary for direct grafting of the talus. This chapter focuses on the surgical management of a patient with a failed primary surgical procedure. The management of specific complications will be discussed, and technique pearls will be given to avoid complications.

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Abbreviations

ACI:

autologous chondrocyte implantation

CT:

computerized tomography

MACI:

matrix-induced autologous chondrocyte implantation

MRI:

magnetic resonance imaging

OATS:

osteochondral autograft or allograft transfer system

OCD:

osteochondritis dissecans

OLT:

osteochondral lesion of the talus

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Authors and Affiliations

  1. Suburban Orthopaedics, 1110 W Schick Rd, Bartlett, IL, 60103, USA

    Kyle S. Peterson

  2. Orthopedic Foot and Ankle Center, 300 Polaris Parkway, Suite 2000, Westerville, OH, 43082, USA

    Christopher F. Hyer

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  1. Kyle S. Peterson
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  2. Christopher F. Hyer
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Correspondence to Christopher F. Hyer .

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Editors and Affiliations

  1. Capital Orthopedics and Sports Medicine, Clive, Iowa, USA

    Michael S. Lee

  2. Akron General Orthopedics, Inc., Akron, Ohio, USA

    Jordan P. Grossman

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Peterson, K.S., Hyer, C.F. (2017). Osteochondral Lesions of the Talus. In: Lee, M., Grossman, J. (eds) Complications in Foot and Ankle Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-53686-6_26

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  • DOI: https://doi.org/10.1007/978-3-319-53686-6_26

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